Gangliosides are sialic acid-containing glycosphingolipids and abundant in the brain. Some studies showed that glycosphingolipids not only could improve the differentiation of neurons, neurite outgrowth and synaptogenesis, but also could modulate neuronal plasticity and improve neurological function after cerebral damage. GM1 was so far most widely studied glycosphingolipids. It is believed that the regulatory functions for calcium homeostasis and the interaction between GM1 and neurotrophins are essential in the mechanisms underlying its neuroprotection. In addition, GM1 has also anti-excitotoxicity, anti-oxidation and vasodilation properties. Various forms of chronic neurodegenerative diseases and hypoxia/ischemic encepha-lopathy are characterized by progressive loss and apoptosis of neurons, the neuroprotective and neruotrophic effects of GM1 could play pivotal role in the treatment of these diseases. Nowadays, GM1 was widely used for the treatment of Parkinson's disease, stroke, hypoxia-ischemic encephalopathy, craniocerebral trauma, spinal cord injury and peripheral neuropathy. Further researches for the mechanisms of GM1 will provide new strategies for the treatment of central nervous system diseases.

3 grades on the corresponding areas with compare to normal person, the positive rate of BEAM ia patient with CVD was 90.4%, more than that of the result of routine EEG(73%).

ObjectiveTo assess the value of legs passively lifted as an indicator of fluid responsiveness in mechanically ventilated patients with severe sepsis.Methods Twenty-eight mechanically ventilated patients with severe sepsis admitted from May 2010 to May 2011 for volume resuscitation were collected.Patients with non-sinus rhythm or arrhythmia and parturients were excluded. Variation of hemodynamics of the patients in a semi-recumbent position,after passive leg raising (PLR) and after volume expansion (500 ml 6％ hydroxyethyl starch infusion within 30 mins) was studied by using the technique of pulse indicator continuous cardiac output (PiCCO) system.The volume resuscitation were resulted into two groups,responder and non-responder,as per △SVI (stroke volume index) over 15％.HR,arterial systoicblood pressure (ABPs),arterial diastolic blood pressure (ABPd),mean arterial blood pressure (ABPm),mean central venous pressure (CVPm) and cardiac index (CI) were compared between two groups.The changes of ABPs,ABPm,CVPm and SVI after PLR and after fluid resuscitation werc compared with those before PLR and fluid resuscitation.The ROC curve was drawn to evaluate the value of △SVI and △CVPm in predicting volume responsiveness. SPSS 17.0 software was used for statistic analysis. ResultsOf 28 patients,8 were responders and 10 were non-responders.In responders after PLR,some hemodynamic variables including ABPs,ABPm and CVPm were significantly increased [(100.1 ± 18.1) vs.(115.9 ±13.1),P=0.005; (68.1±12.4) vs.(77.8±13.0),P=0.03and(7.2±3.4) vs.(10.1±4.1),P=0.03,respectively ].After PLR,the area under curve (AUC) of the ROC curve of △SVI and △CVPm to predict the responsiveness after fluid resuscitation were 0.897 ± 0.059 (95 ％ CI 0.762-1.000) and 0.819±0.081 (95％CI 0.661-0.977),respectively.When the cut-off levels of △SVI and △CVPm were 10.5％ and 12.7％,the sensitivities were 72.2％ and 72.2％,the specificities were 90％ and 80％.Conclusions Changes in △SVI and △CVPm induced by passive leg raising are accurate indices for predicting fluid responsiveness in mechanically ventilated patients with severe sepsis.

In the medical field, the innovation education is to cultivate residents in China, which is an important way to senior medical elite. By analyzing competency-based neurosurgery residency training mode, the training methods for innovative ability of competency-based neurosurgeon are further discussed, for the purpose of reforming the training mode of neurosurgeon, improving creative ability and scientific clinical thinking ability.

Objective To investigate the changes of serum vascular endothelial growth factor (VEGF) and its effects on pathoge nesis in children with Henoch - Schonlein purpura(HSP). Methods Serum VEGF was detected by sandwich ELISA in 20 children with HSP in acute phase and 15 children in remission phase and 16 normal children. Results The serum VEGF levels in children with HSP in acute phase(533.85? 127.63) ng/L were significantly higher than those in remission phase (160.47 ? 37.39) ng/L and normal control (68. 93 ? 19. 16) ng/L. One - way analysis of variance between them was significant difference ( F = 158. 86 P

Previous studies have proved that the effect of statins in both primary and secondary prevention of ischemic stroke, however, whether acute ischemic stroke needs to be treated with statins and the effect of statins pretreatment on acute ischemic stroke remain unclear. This article reviews the recent representative studies in this field, and analyzes the effects of the application of statins in the treatment of acute ischemic stroke on prognosis.

Objective To evaluate the cerebrovascular reserve(CVR) in patients of ischemic stroke with cerebrovascular stenosis by Xenon-enhanced CT. Methods Twenty subjects of ischemic stroke with cerebrovascular stenosis were recruited. All subjects were examined by Xenon-enhanced CT before and after acetazolamide (ACZ) challenge test to quantitatively measure the regional cerebral blood flow (rCBF) and CVR. Results We compared the rCBF in the corresponding region supplied with stenosed artery (divided manually) with that in the region of normal side. There was no significant difference in resting rCBF but in CVR [ipsilateral side vs. normal side ( 5.9 ± 24. 3 ) % vs ( 25.9 ± 32. 6 ) % , P ＜ 0. 05]. Conclusion Impaired CVR is an important character of the patients with cerebrovascular stenosis suffered from ischemic stroke.

Objective To present 3 cases of neurilemmoma of adrenal gland. Methods The clinical pathological manifestations,diagnosis and treatment of 3 cases of neurilemmoma of adrenal gland were reviewed. Results Tumor resection was undertaken in all the three and the diagnosis was assessed on pathological study. All the 3 patients have been in good condition and tumor free on 3～5 years of follow up. Conclusions Tumor resection is the treatment of choice with good prognosis.Radiotherapy may be considered as an adjuvant treatment for malignant ones.Definite diagnosis depends on pathological studies.

Neuroimaging technology is the major means in the study of cerebral blood flow. This article reviews all kinds of neuroimaging technologies in identification of perihematomal penumbra in intracerebral hemorrhage,as well as the research status of perihematomal cerebral blood flow in intracerebral hemorrhage.

Objective To evaluate the safety and feasibility of portal CO 2-DSA with fine needle splenic puncture. Methods The splenic tails of seven adult white rabbits were exteriorized by laparotomy, and followed by a 25 gauge fine needle inserting about 1.0 cm into the splenic parenchyma. Portal CO 2-DSA was performed (2.0 ml/s, 10ml) and the images were evaluated. After removal of the needle, the puncture site was observed for bleeding till coagulation occurred. The spleen were taken for gross and histological examination. Results All the CO 2-DSA clearly showed the portal trunk with intrahepatic branches above 3～4 orders, the main splenic vein, and the main mesenteric veins with parts of its branches. CO 2 disappeared from the intrahepatic portal vein over 2～3 minutes. In one animal, the left renal vein and the inferior vena cava were also displayed by CO 2 through communication between splenic vein and renal vein. After removal of the needle, there was small amount of bleeding at the puncture site which ceased spontaneously over 3～5 minutes. In all animals, no extravasation of CO 2 at the puncture site, no subcapsular dissection or intrasplenic hematoma was observed. Microscopically, the splenic capsule appeared intact and there was no evidence of subcapsular hematoma formation.Conclusions Portal CO 2-DSA with fine needle splenic puncture is feasible, safe and efficient. In normal adult rabbit, CO 2 may help to visualize the left renal vein and inferior vena cava through communication between splenic and renal vein.